Baclofen is a muscle relaxing medication that is sometimes used to treat alcohol use disorder (AUD). While research on its effectiveness is inconsistent, some evidence suggests it may be promising.

The above information comes from a 2021 study published in Neuropsychopharmacology.

The main advantage of baclofen is that it may be safe to use in people with liver disease, affecting some people with AUD. Despite this, the medication still has risks. High doses may cause dangerous side effects, such as seizures and coma.

Read more about using baclofen for AUD, the related risks, and other AUD treatment options.

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Research shows that AUD is one of the most common conditions in the United States, and medications can be an important part of treating it.

While the Food and Drug Administration (FDA) has approved four drugs to treat AUD, experts say there needs to be more available for people who do not respond to the existing options.

Baclofen is a muscle relaxant.

It is an agonist, which means it binds to GABA receptors. GABA is an amino acid that inhibits the central nervous system (CNS). The FDA has approved it to treat muscle spasticity from multiple sclerosis, and it is also used in people with spinal cord conditions.

At present, the FDA has not approved baclofen for AUD.

Most doctors who use baclofen for this purpose do so in certain European countries and Australia. In particular, they use it for people who have not responded well to existing approved medications.

Some doctors in the U.S. prescribe baclofen as an “off-label” drug. Although the drug has FDA approval for other conditions, they prescribe it for a different purpose.

Experts say they need more research to determine how effectively baclofen can treat AUD. The studies discussed below show that although the drug may reduce cravings and increase abstinent days, its efficacy may be down to the placebo effect.

Increases abstinent days

According to a 2021 clinical trial, baclofen holds promise for treating AUD.

The trial tested it on 120 people with the condition. Researchers compared the effects of a placebo with 30 milligrams (mg) of baclofen and 90 mg of baclofen.

Data analysis suggested that the medication may increase abstinent days and decrease heavy drinking. Males benefited more from the 90 mg per day dose, while females benefited more from the 30 mg per day dose.

Reduces cravings

Research from 2016 also resulted in favor of baclofen.

In a study of 113 people with AUD, the medication reduced cravings and alcohol consumption — even among those with poor motivation to stop drinking.

No different than a placebo

A 2018 meta-analysis reviewed 12 clinical trials involving 1,128 participants with AUD.

Unlike the above two studies, it found no difference between the effects of baclofen and a placebo. This is important because as a meta-analysis, this research evaluated the effects of multiple trials studying a large pool of people.

Baclofen causes two types of side effects. One affects people on lower or normal doses, and the other affects people on higher ones.

The low and normal-dose side effects are largely harmless and often disappear on their own or in response to dose reduction.

Common ones include:

  • drowsiness
  • dizziness
  • weakness
  • fatigue

Higher-dose side effects are potentially dangerous. They include:

  • slow, shallow breathing
  • sleep apnea
  • seizures
  • mental confusion, delirium, or both
  • severe mood disorders with the risk of suicide
  • coma

Additionally, baclofen causes sedation. This means it can be dangerous in certain situations, so a person should not take baclofen before:

  • driving a car
  • using dangerous tools
  • operating heavy machinery

To reduce the likelihood of side effects and withdrawal symptoms, a person taking baclofen should start and stop taking it gradually. Withdrawal symptoms may include:

  • seizures
  • agitation
  • confusion
  • delirium

Baclofen is a CNS depressant that slows brain activity and causes sedation.

It can be dangerous when taken with other sedatives, including:

The National Institute of Health (NIH) recommends several different treatment options for people with AUD, including medication, therapy, and support groups.

Medications

FDA-approved medications for AUD include:

  • disulfiram (Antabuse)
  • acamprosate (Campral)
  • oral naltrexone and extended-release naltrexone (Vivitrol)

Behavioral therapies

In this treatment, licensed therapists provide talk therapy or counseling. They teach coping strategies and increase motivation for preventing relapses.

Mutual support groups

These groups offer peer support for stopping drinking. They are available in most communities at no or little cost.

An example is Alcoholics Anonymous (AA). In combination with behavioral therapy and medications, the groups provide valuable support.

Learn more about treatments for alcohol use disorder.

Researchers have studied baclofen’s use as a treatment for AUD. Although some studies are encouraging, others suggest the medication has no value for the condition.

Any person taking baclofen for AUD should avoid driving and operating dangerous tools or machinery. They should also be aware of the risks posed by higher doses or from taking it with other CNS depressants.